The long weight is over
MANILA, Philippines - Certainly, getting rid of the unsightly bulges and attaining a more attractive body shape would be a great payoff for shedding all the extra pounds. But just as important are the numerous health benefits that come with working off the fat. Obesity, after all, has been identified as a leading cause of preventable death.
“Obese people have a higher risk for diabetes, high blood pressure, elevated cholesterol levels, gallbladder problems, and coronary artery disease,” says Dr. Henry T. Horrilleno, the bariatric surgeon member of Makati Medical Center’s Weight Wellness Team. “Some cancers, such as those of the prostate, breast, and colon are more frequent in the obese population. Breathing difficulties may also occur.” But while the solutions of decreased food intake and more time spent exercising may seem simple, actually losing the kilos of fat may seem an insurmountable and desperate goal. “For the morbidly obese, sticking to a diet and exercise regimen can prove difficult and painful, especially since the added weight can cause joint problems,” continues Dr. Horrilleno.
An alternative treatment to attain significant weight loss is through surgical options. Who is qualified for bariatric surgery? There are set guidelines but generally, it is for those who are at least 100 lbs. over their ideal weight.
Dr. Horrilleno, a member of both the American College of Surgeons and American Society for Metabolic and Bariatric Surgery, identifies the two types of surgery for obesity as “malabsorptive” which shortens the digestive tract, and “restrictive” which reduces the amount of food that the stomach can hold. Gastric bypass is both a restrictive and malabsorptive procedure wherein the stomach is stapled to make a smaller stomach pouch. Since most of the stomach and part of the intestines are bypassed, the patient is unable to eat as much, and fewer nutrients and calories from food are absorbed. On the other hand, the vertical banded gastroplasty (VBG) is a restrictive surgery where the surgeons use staples to make a small stomach pouch.
Another option is sleeve gastrectomy where the stomach is surgically reduced to about 15 percent of its original shape to form a banana-shaped “sleeve” or tube. Expectedly, the changes made to the stomach are permanent.
However, one of the most acceptable procedures, Dr. Horrileno points out, is the lap-band adjustable gastric banding system. By placing an adjustable silicone band around the upper part of the stomach, there is a reduction of how much the stomach can hold. “The band is approved for ages 18-65 in the United States,” says Dr.Horrilleno. “It is the least invasive way to use surgery to reduce the food-carrying capacity of the stomach. The lap-band is pulled around the stomach to form a ring and a lock securely holds the band in a circle. The device is currently the preferred bariatric surgery option because unlike more drastic and permanent surgical options like the sleeve gastrectomy, it can be replaced or removed any time.”
Since insertion of the device is through laparoscopic surgery, pain is significantly reduced and there are fewer wound complications. In turn, this results in faster healing time. “Laparoscopic surgery is a minimally invasive surgery,” explains Dr. Horrileno. “The surgeon makes small incisions in the abdominal wall and inserts narrow, hollow tubes where surgical instruments and a small camera are passed through. He can then see inside the abdomen because the images taken by the camera are projected onto a monitor.”
Dr. Horrilleno obtained his excellent training under Dr. Alan Wittgrove, the pioneering surgeon in laparoscopic ROUX-EN-Y gastric bypass surgery. He has had experience in bariatric surgery in the United States for at least 10 years. To get the best results after bariatric surgery, he recommends the following guidelines: Eat only three small meals a day. Eat slowly and chew thoroughly. Do not stuff yourself. Stop eating as soon as you feel full. Do not drink while you are eating; Do not eat between meals. Eat only good quality foods. Drink enough low-calorie liquids during the day. Exercise at least 30 minutes a day.
He maintains, “The bottom line is for the patient to eat less. This is the purpose for all these procedures. Bariatric surgery should not be taken lightly because there could be serious complications.”
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Dr. Henry Horrilleno holds clinic at Suite 201, Makati Medical Center, Amorsolo Street, Makati City. He can be reached at 816-0146 (direct line) or 888-8999 local 7201 or e-mail Dr.HTH8@yahoo.com.
